Advocacy News & Events

Senate HELP Committee Holds Hearing on Mental Health Reform

On Wednesday, January 20th, the Senate Health, Education, Labor and Pensions (HELP) Committee, held a hearing on mental health reform on the 114th Congress. The hearing focused primarily on the provisions of the Mental Health Reform Act (S. 1945)– legislation introduced by Committee members Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA). While the Committee did not vote on this legislation, Chairman Lamar Alexander (R-TN) said he wants to “move promptly” to put forward a series of recommendation from a variety of mental health proposals.

Many of the broad themes discussed included increasing access to mental health care in rural areas, addressing the provider shortage and reducing the stigma around mental health. In addition, there was talk about addressing the Health Insurance Portability and Accountability Act (HIPAA) privacy laws. “Touching HIPAA is like touching an electric wire, but maybe that's what we're paid to do sometimes.” said Chairman Alexander. So far there are two competing proposals that would address alleged problems for people who struggle to find out information about a family member under psychiatric care. The proposal from Rep. Tim Murphy would directly amend HIPAA law by providing a new exception to the HIPAA privacy rule. A competing proposal from Doris Matsui (D-CA) would codify the content of a 2014 guidance (PDF) issued by HHS' Office for Civil Rights without amending the HIPAA. It will also promote better understanding of what the privacy law allows—which will help providers in using their discretion in mental health situations.

Chairman Lamar Alexander (R-Tenn.) and ranking Democrat Patty Murray of Washington want to use reauthorization of the Substance Abuse and Mental Health Services Administration as the primary vehicle for mental health bill, which the committee could then add to, said Sen. Bill Cassidy (R-La.).

The witnesses for this hearing included: Brian Hepburn, National Association of State Mental Health Program Directors; Penelope Blake, Emergency Nurses Association; William Eaton, Johns Hopkins Bloomberg School of Public Health; and Hakeen Rahim, Live Breathe.

As a result of the hearing, Chairman Alexander said he is working with the Senate Judiciary committee, which shares jurisdiction on mental health issues, on a larger sweeping comprehensive mental health bill that pulls from a number of competing bills, including one that deals with the opioid epidemic.

AAMFT continues to meet with members and staff of the relevant committees in working to try and include language that would allow MFTs to be reimbursed by Medicare in any legislation that moves forward. The bill, HR 2759, would ensure that 40% of the entire mental health workforce (MFTs and counselors) are no longer excluded from Medicare reimbursement.

On December 18th, President Obama signed into law what is known as the “omnibus” appropriations spending bill that would fund the government through September of 2016. This is following the passage of the two year budget deal that was struck in October. That bill included a lift of the sequester spending caps that have been in effect since 2013 and included an agreement to increase discretionary spending by about $80 billion over two years. A budget is largely a symbolic blueprint that dictates to appropriators how, and how much, to spend. The omnibus appropriations bill is the end result of that effort and contains several provisions relating to funding for mental health. Below is a brief rundown of these provisions.

The National Institutes of Health received a $2 billion funding increase, the largest budget increase for NIH in over 12 years;

a $91 million increase in funding to combat the growing heroin and prescription drug abuse epidemic;

Fully funds court-ordered treatment for severely or chronically mentally ill individuals known as Assisted Outpatient Treatment (AOT). This would allow courts to mandate treatment for mentally ill people who have shown to be chronically in and out of jails or psychiatric hospitals. Grants for the similar programs have recently become a contentious issue in Rep. Tim Murphy's (R-PA) mental health bill. AAMFT is has serious concerns about the Murphy’s bill in its current form because it would require states to begin using AOT as a condition of receiving federal mental health dollars as well as make changes to HIPAA laws that could lead to an erosion on patients’ rights.

more than $1.5 billion for the National Institute of Mental Health;

more than $1.1 billion for the Substance Abuse and Mental Health Services Administration;

$15 million in funding for the Mental Health First Aid program, which provides training for people to identify signs and symptoms of mental illnesses and addictions, and to identify how to intervene and help in a crisis;

$10 million for mental health courts and adult and juvenile collaboration program grants;

$73 million for grants to states to upgrade criminal and mental health records for the National Instant Criminal Background Check System;

$532.6 million for Mental Health Block Grants, which is an increase of $50 million above last year’s levels;

$414.6 million for Mental Health Programs of Regional and National Significance, which is an increase of $36 million above last year’s levels.

$1.9 billion for substance Abuse Prevention and Treatment Block Grants –, an increase of $38.2 million above last year’s levels. These funds provide funds to support and expand substance abuse and prevention services based on local need.